The budget bill also formalizes how Wisconsinites could get health insurance as the country ramps into compliance with the Affordable Care Act. The governor's budget turned away federal dollars that would have expanded Medicaid. In its place, the budget revamped the state program called BadgerCare Plus. Wisconsinites between the age of 19 and 64 who meet poverty level income requirements and who are not eligible for Medicare could qualify for BadgerCare plus. The updated BadgerCare Plus will need a federal waiver. The state Department of Health Services says that will be filed in August. In the meantime, deputy secretary of the department, Kevin Moore, will oversee a series of statewide town hall meetings designed to bring people up to speed on the revamped BadgerCare Plus option and he joins us now. Thanks very much for doing so.

Kevin Moore:

Thank you for having me.

Frederica Freyberg:

Well, Wisconsin's plan does away with this BadgerCare Core plan that had like 148,000 people on the waiting list or something.

Kevin Moore:

Correct.

Frederica Freyberg:

And because you've reduced the eligibility requirements down to 100%, you also put 82,000 people off that waiting list onto this new plan, which is great for those people. But what about the other 66,000 that then are out there and they don't have an option, they're not even on a waiting list? What are you telling those folks?

Kevin Moore:

Well, you're right. The governor's budget proposal really does reform the way we're going to deliver services in Medicaid and, as you mentioned, for people who live in poverty who are childless adults right now will have access to the full Medicaid benefit, as opposed to the core plan, which is essentially a more lightened up version of health insurance. For the individuals not are not going to be covered under BadgerCare Plus and the new Medicaid benefit, the department is working to ensure that there's a transition into the newly eligible Affordable Care Act. We’ve called it exchanges. The federal government now is calling it the marketplace. And this is where individuals will have access to subsidies from the federal government to purchase commercial health insurance. It's part of the governor's overall goal of cutting the uninsured rate in Wisconsin by half. It's essentially these two elements, on the BadgerCare Plus side of giving childless adults access to coverage that they didn't have before, and then utilizing the exchanges for the balance of the population.

Frederica Freyberg:

And then there are, I gather, about 100,000 people who now won't be eligible because of income guidelines and other kind of eligibility requirements for the BadgerCare Plus? They too are moving into the marketplace, as you call it, or the exchanges?

Kevin Moore:

Yeah. For parents and caretakers that are above the federal poverty level up to 200%, or double the federal poverty level, those individuals will have access to health insurance through the marketplace or the exchange. And so the department is working on-- in conjunction on our partners at the Office of the Commissioner of Insurance but also stakeholders, advocates, really trying to focus on how to help people navigate from where they are now into the commercial market place. And so we are committed to that process and that's part of the larger reform that the governor initiated in this budget.

Frederica Freyberg:

Now, notwithstanding the fact that the high court said states could choose whether or not to take this Medicaid expansion, is it likely that the feds will grant Wisconsin the waiver given that, A, we didn't accept that expansion and, B, we kind of changed up the way we're delivering it.

Kevin Moore:

This is a great question, and it’s something that the department has been very aggressive on. The state’s Medicaid director, Brett Davis, and his team recently was out in Washington, met with CMS. We've been very proactive with the federal government in really outlining our vision of where we want to go. It’s been very receptive. We feel very confident that the federal government is on the same page as we are. They are very interested in our desire to make it a Medicaid benefit as opposed to an older benefit under the previous administration, of a lightened up the core benefit, as you called it. We want to just give a Medicaid benefit, which includes enhanced mental health, enhanced substance abuse, which, again, is consistent with the governor's budget proposal, really focusing on mental health coverage for people. We've been very encouraged with those discussions. We continue to work weekly with them to make sure that we're all on the same page. And the federal government does have a lot of work going on out there as well. And so to the extent we can help move that along, we're more than willing to partner with them.

Frederica Freyberg:

One question people might have as they head out to these town hall meetings to get more information is, what happens if they can't afford the marketplace insurance through the exchanges? Do you anticipate a certain number of people just will go without coverage because none of these options work for them?

Kevin Moore:

And that's a really great question, and I think it's something where the construction of the plans, the construction of the federal law in terms of how subsidies reach individuals, we are still waiting for additional guidance. We're very interested in how that works. But ultimately it was coined the Affordable Care Act. These exchanges and marketplaces are designed to provide access to affordable health insurance. We've also done some test runs previously in the last budget. The department worked on a number of waivers on a specific set of populations to really test the affordability aspect of what the Affordable Care Act claims is affordable. And we saw a lot of people that did take up the new-- Even with additional co-pays and additional premium costs, they took it up because they still saw the value in providing health coverage for themselves and their families. Again, it's going to be a very intense time period, both for the state as well as for our partners in the federal government, but we really hope that people are paying attention, that they listen, and that we’re listening to them as well.

Frederica Freyberg:

All right, Deputy secretary Kevin Moore, thank you very much.

Kevin Moore:

Thank you very much.

Frederica Freyberg:

There are three upcoming information sessions on the BadgerCare plus program. There's one in Eau Claire on Wednesday, July 10, a Milwaukee session on the 11th, and one in Green Bay also on the 11th. All of the locations and addresses can be found on our website at wpt.org/hereandnow.